scholarly journals Comparative study of the outcome of surgical decompression in Ludwig’s angina by conventional skin incision versus multiple interrupted skin incisions

Author(s):  
Kulkarni Manik Rao ◽  
Navneeth T. P. ◽  
Vivek S. ◽  
Sonu S. Rathod

<p class="abstract"><strong>Background:</strong> Ludwig’s angina is a potentially life threatening infection characterized by a rapidly progressing, bilateral gangrenous cellulitis of all the three primary mandibular spaces namely submental, submandibular and sublingual. If left untreated the cellulitis can progress swiftly to produce obstruction of airway and death. Despite that, no specific guidelines exist and management is greatly dependent on clinical judgement and experience.</p><p class="abstract"><strong>Methods:</strong> Forty cases of patients with Ludwig’s angina, attending the department of otorhinolaryngology were included in this study and were randomly allocated into conventional incision (CI) and multiple incisions (MI) groups. Following informed written consent, either conventional incision or multiple small incisions were used for drainage and the outcomes analysed.  </p><p class="abstract"><strong>Results:</strong> The mean age of patients was 28.4 years and majority of the patients belonged to 20-40 years age group. Male to female ratio was 2.3:1.The most common etiology was odontogenic. The outcome of both the conventional group and multiple small incisions group were comparable. The mean hospital stay of the conventional group was 10.25 days and multiple incisions group was 5.31 days which was statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> Multiple small incisions for the drainage of Ludwig’s angina is a safe and less invasive alternative method, with the advantages being shorter hospital stay and better cosmesis without an increase in complications.</p>

Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Piotr Morasiewicz

The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopy performed in an orthopedic department of a university hospital in Poland. This study compared the data on all shoulder and knee arthroscopy procedures performed in two different periods: The period of the COVID-19 pandemic in Poland (from March 4, 2020, to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019, to October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration. The total number of arthroscopy procedures conducted in the evaluated period in 2020 was approximately 8.6% higher than that in the corresponding 2019 period. The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019. The male-to-female ratio was shown to be lower at .85 during the pandemic, having decreased from 1.5 in 2019. The COVID-19 pandemic did not reduce the number of arthroscopy performed at our center, and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.


2021 ◽  
Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Piotr Morasiewicz

Abstract Background: The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopies performed in an orthopedic department of a university hospital in Poland.Methods: This study compared the data on shoulder and knee arthroscopy procedures performed in two different periods: the period of the COVID-19 pandemic in Poland (from March 4, 2020 to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019–October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration.Results: The total number of arthroscopy procedures conducted in the evaluated period in 2020was approximately 8.6% higher than that in the corresponding 2019 period.The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019.The male-to-female ratio was shown to be lower at 0.85 during the pandemic, having decreased from 1.5 in 2019Conclusions: The COVID-19 pandemic did not reduce the number of arthroscopies performed at our center and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.


Author(s):  
Ekaniyere EB

Background: Even though the decompression of the cellulitis phase of Ludwig’s angina (LA) by surgical or pharmacological approach is well documented, it is unclear which approach is more effective. Objective: We aim to compare the outcome of treatment between surgical versus pharmacological decompression in patients with LA. Subjects and Methods: A retrospective cohort study was designed. Data were collected from the case notes of patients that met the inclusion criteria from 2004 to 2018 at the University of Benin Teaching Hospital, Nigeria.The data were age, gender, type of decompression approach, length of hospital stay (LOS) and airway compromise. Result: A total of 62 patients comprising 37(59.7%) surgical decompression group and 25(40.3%) pharmacological decompression group were studied. Thirty-six (58.1%) males and 26 (41.9%) females were studied. Their mean age and standard deviation were 40.6 years and 11.9 years respectively. The mean length of hospital stays between the pharmacological and surgical decompression groups were 8.05 days and 13.8 days respectively. The incidence of airway compromise in the surgical decompression group was 19.9% lower than that of the pharmacological decompression group (P=0.47), which was not significant. The type of decompression approach also failed to influence the incidence of airway compromise (P = 0.41). Conclusion: The use of surgical versus pharmacological decompression does not significantly alter the incidence of airway compromise in the management of LA. The Patients that had surgical decompression had a shorter stay in the hospital as compared to those who had pharmacological decompression. This was not statistically significant.


2020 ◽  
Vol 47 (3) ◽  
Author(s):  
D.C. Obu ◽  
M.C. Orji ◽  
U.V. Muoneke ◽  
U.V. Asiegbu ◽  
G.O. Ezegbe

Background: Accidental childhood poisoning is a recognized preventable cause of morbidity and mortality among children worldwide. This studywas aimed at determining the prevalence, pattern, and outcome of childhood poisoning among children in Abakaliki, Ebonyi State. Material and Methods: Medical records of all cases of accidental childhood poisoning admitted into Children’s emergency room (CHER) of the health facility of study between January 2014 and December 2018 were retrospectively identified and relevant data extracted and analyzed usingSPSS version 22. Results: Out of the 7,700 children that presented to CHER over a 5- year period, 42 were cases of poisoning, giving prevalence rate of 0.5%. Of the 42 cases, only 20 case notes were retrieved. The male to female ratio was 2.3:1 while the ages ranged between 6months and 14 years with the mean age of 3.06±2.88. Kerosene poisoning had the highest proportion of 50.0% (10/20) with the overall mortality rate of 5.0% (1/20).The relationship between age, place of residence and outcome in poisoned children was statistically significant (p = 0.038, 0.045 respectively). Conclusion: Accidental childhood poisoning is common in Abakaliki. Kerosene still remained the major agent while male toddlers were most  vulnerable. There is need to intensify enlightenment campaigns and education of the public about the hazard of improper storage of kerosene and other implicated substances at home. Keywords: Accidental poisoning, Childhood, Kerosene


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1219
Author(s):  
Prashant Pant ◽  
Oshan Shrestha ◽  
Pawan Budhathoki ◽  
Nebula Devkota ◽  
Prabin Kumar Giri ◽  
...  

Ludwig’s angina (LA) is a rapidly spreading and potentially life-threatening infection having an odontogenic infection as the most common source. It involves the floor of the mouth and neck. Modernization in medical care has made this entity rare and of low mortality at the present but it is still feared as a lethal entity due to rapidly progressive airway obstruction that follows. Here we report a case of a 15-year-old male who suffered from LA. Presenting symptoms and findings of the examination helped in the clinical diagnosis. Immediate intubation, use of broad-spectrum antibiotics, and treatment of complications aided the patient’s recovery. LA should be considered for differential diagnosis in the case of neck swelling especially in those having a history of poor oral hygiene and recent dental procedures. Management of LA and its complications should always involve doctors from multiple disciplines.


2021 ◽  
Vol 15 (10) ◽  
pp. 2826-2828
Author(s):  
Muhammad Ahsan Zafar ◽  
Sidra Khalid ◽  
Talha Munir

Objective: To assess the diagnostic accuracy of rapid diagnostic kits test for diagnosis of malaria taking microscopy as gold standard Methodology: A total of 375 cases with age range 18-65 years of either gender as suspected for malaria were included in the study. We excluded all those cases already taking anti-malarial drugs. The study was conducted at Chughtais Lahore Lab, Lahore. Required blood sample were obtained following aseptic measures. Malaria RDT SD Bioline Malaria Antigen Pf/Pan (Catalogue No. 05FK60, Standard Diagnostics Inc, Hagal-Dong, Korea, from now on referred as “SD RDT”) was used. Patients were labeled as positive or negative on the basis of reports from hematology department assessed by microscopy and patients were labeled as positive or negative Results: The mean age of the patients was 41.84±13.44 years, male to female ratio of the patients was 1.01:1. The sensitivity, specificity, and diagnostic accuracy of the RDT for diagnosing malaria was 96.79%, 96.28% and 96.53% respectively taking microscopy as gold standard Conclusion: Rapid diagnostic kits is very useful reliable test with high diagnostic accuracy for diagnosis of malaria taking microscopy as gold standard Keywords: Microscopy, Rapid Diagnostic kits, Malaria,


2021 ◽  
Vol 14 (4) ◽  
pp. e240429
Author(s):  
Catarina Mendes Silva ◽  
Joana Paixão ◽  
Pedro Neves Tavares ◽  
João Pedro Baptista

Ludwig’s angina is a deep neck space infection defined as a rapidly progressive bilateral cellulitis of the submandibular space. In spite of being an uncommon entity in developed countries and the reduction of mortality and morbidity due to modern era of antibiotics, improved imaging and airway management, it is still an important and potentially life-threatening condition. The authors present 3 cases of Ludwig’s angina that occurred in a developed country, and that required admission in intensive care unit and extensive surgical and medical treatment.


2020 ◽  
Vol 14 (1) ◽  
pp. 27-30
Author(s):  
Md Ashraful Hoque ◽  
Kashfia Islam ◽  
Selina Akter

Adverse events due to platelet pheresis are not unheard of citrate related reactions being the most common. Most of these events are mild and self limiting. The current study describes adverse events in platelet pheresis using modern apheresis systems. This prospective study included 1455 platelet pheresis procedures done from July 2016 to December 2017. Procedures were performed on Hemonetics MCS+, Trima Accel and Cobe spectra cell separators. The endpoint of each procedure was a yield of 3 × 1011 platelets (PLTs) per unit. Donor adverse reaction if any was managed, reported, and documented. The median age of donors was 31 years with male to female ratio of 13:1. The median body surface area and body mass index were 1.64 m2 and 22.4 kg/m2, respectively. The mean PLT count of donors was 199.8 × 103/uL with a mean hemoglobin value of 13.6 g/dl. ACD infusion was significantly more in the Hemonetics MCS+, (P< 0.01). Donation time was least with the Trima compared to Hemonetics MCS+ (P< 0.01) and Cobe (P< 0.001). Total whole blood volume processed was higher in Hemonetics MCS+, (P< 0.01). Paresthesia due to citrate toxicity was the most common adverse reaction (65.3%), and vascular injury was observed in only five donors. The overall incidence of adverse reaction was 3.4%. Serious adverse events were not observed. The modern generation apheresis machines are more donors friendly and cause less adverse reactions compared to the older versions. Good donor screening, optimized donor physiognomic and hematological values and skilled operators are the key factors in reaction reduction by apheresis. Faridpur Med. Coll. J. Jan 2019;14(1): 27-30


2019 ◽  
Vol 17 (1) ◽  
pp. 16-19
Author(s):  
Roman Kidwai ◽  
Anup Sharma

Background: About 30% of patients presenting to surgical outpatient department has lower gastrointestinal (LGI) symptoms. Colonoscopy is a low risk and at the same time investigation of choice in these patients which allows visualization of the entire colon and the terminal portion of ileum. This study was done to find out the diagnostic accuracy of colonoscopy in relation to the clinical symptoms of the disease.  Methods: This was a prospective, hospital based study from February 2014 to March 2019 carried out at Nepalgunj Medical College and Teaching Hospital. The colonoscopy diagnosis was compared with the clinical symptoms and further confirmed with histological examination.  Results: 341 patients underwent colonoscopy. There were 234 (68.62%) males and 107 (31.37%) females with the male to female ratio of 2.18: 1. The age ranged from 16 to 81 with the mean age of 59.63±10.37. The most common presenting symptom was per rectal bleeding (40.34%) the after were alteration in bowel habit (17.30%), constipation (12.90%), hematochezia (11.43%). The least common indication for colonoscopy was unexplained anemia. Haemorrhoids were the most common findings consisting 32.55%. In 19.94% it was normal. Majority had various inflammatory conditions, among them 10.85% had proctocolitis, 2.34% were suspected to have ulcerative colitis. There were 17(4.98%) patients with colonic and 13(3.18%)with rectal carcinoma. 10.55% had colorectal polyps. Out of 111 patients suspected to have hemorrhoids clinically 102 had same findings on colonoscopy. Similarly 34 patients presenting with chronic diarrhea with bleeding and 59 with alteration in bowel habit where inflammatory conditions were suspected had similar findings on colonoscopy in 29 and 34 patients respectively. Similarly the suspicion of malignancy on clinical basis was also correlated on colonoscopy. The inflammatory conditions diagnosed on colonoscopy were confirmed in 85.04 % by histology. Similarly malignancy and the presence of polyps diagnosed on colonoscopy were confirmed by histology in 97.05% and in 97.22% cases respectively. Conclusion: Colonoscopy is a safe and effective investigation to diagnose various colorectal conditions. There was a correlation between the clinical symptoms and the colonoscopicdiagnosis especially in conditions like inflammatory and neoplastic colorectal diseases. When combined with histology the diagnostic accuracy can be near 100% in conditions like inflammatory and benign or malignant diseases.


2019 ◽  
Vol 4 (1) ◽  
pp. 645-648
Author(s):  
Bishwa Nath Adhikari ◽  
Pramod Sharma Gautam ◽  
Shishu Upadhyay ◽  
Uday Chandra Prakash

Introduction: Globally, the most common cause for diminution of vision is refractive errors and the number of patients with refractive errors is increasing day by day. The Auto-refraction (AR) is quick and patient friendly procedure as compared to retinoscopy and subjective refraction in finding out refractive errors. Hence, the accuracy of Auto-refractometer in terms of subjective acceptance (SA) should be taken into account before prescribing optical correction based on findings of that particular model of Auto-refractometer. So, this study is directed towards analysis of the accuracy of GRK-2200T Auto-retieratometer in terms of acceptance by comparing findings of AR with that of SC. Objectives: The aim of this study was to assess the refractive status of patient's eyes using auto refractometer (GRK-2200T auto-retierato meter) and to estimate the agreement of it in terms of accuracy in acceptance of subjective correction by the patient. Methodology: A hospital based prospective comparative study conducted on 226 eyes of 113 patients who visited out-patient department (OPD) of Ophthalmology at Nobel Medical College and Teaching Hospital (NoMCTH), Biratnagar diagnosed with Myopia, Hyperopia and Astigmatism. Duration of study was 4 months from 2nd October, 2018 to 2nd February, 2019. All data thus collected was subjected to statistical analysis by using SPSS version 22. Result The mean age of the study subjects was 26.91±7.79 years with male to female ratio of 0.47. When spherical power, cylindrical power and the axis are taken into consideration together, only 13.3% of the total tested eyes subjectively accepted the AR values unchanged. On subjective correction, 32.7% of the tested eyes accepted spherical power while 46.5% accepted cylindrical power and 50.9% accepted axis of AR unchanged. About 52.2% of the total eyes examined fall within the deviation of spherical equivalent (SE) of ±o.25D and up to 67.3% of them fall within the deviation of ±o.50D. Conclusion The auto refraction by GRK-2200T auto-retieratometer was found to be satisfactory for a preliminary refraction but not satisfactory as substitutes for conventional subjective refraction. However, auto refraction values obtained by GRK-2200T auto-retieratometer could be important in order to accurately prescribe the cylindrical power as well as its axis than the spherical component.


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